Using Technology in Urban Areas: Preparing for the Future April 26, 1999 Frank Ferrante Senior Manager Mitretek Systems, Inc. Presented to The Emerging Health Information Infrastructure Conference (HII99) Improving Health in a Digital World Sponsored by the Friends of the National Library of Medicine (FNLM) Washington, D.C.
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Using Technology in Urban Areas: Preparing for the Future April 26, 1999 Frank Ferrante Senior Manager Mitretek Systems, Inc. Presented to The Emerging.
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Using Technology in Urban Areas: Preparing for the Future
April 26, 1999
Frank FerranteSenior Manager
Mitretek Systems, Inc.
Presented to
The Emerging Health Information Infrastructure Conference (HII99)
Improving Health in a Digital World
Sponsored by the Friends of the National Library of Medicine (FNLM)
Washington, D.C.
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Agenda
Technology: Changes and Trends Digital Healthcare Products Applications Current and Future Technologies Summary
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Technology: Changes Exponential
Multimedia applications:Messaging, documents, desktop conferencing, image storage/retrieval,TV distribution
Internet consumer market to reach 43 million in 2000 from 30+ million households in 1998 {INTERNET2 reaching Gbps Rates)
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$500
$1,000
$1,500
$2,000
$2,500
$3,000
$3,500
$4,000
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Inte
rnet
Mar
ket
in M
illio
ns
1995 1996 1997 1998 1999 2000Source: The Age of Internet: Capitalization on the Data Opportunity, Information and Interactive Service Report, January 9, 1998
– On a single strand of fiber, a point-to-point backbone link would carry an OC-48 SONET signal at a single wavelength
With WDM:– On a single strand of fiber, a point-to-point backbone link
could carry multiple wavelengths (color bands) each wavelength capable of carrying an OC-48 SONET signal
– Point-to-point throughput increases by a factor equal to number of wavelengths accommodated by the WDM equipment (4-8 in 1995)
– Next development trend in WDM is true optical networking via optical cross connects where direct switching of optical signals rather than time slots are performed• Technology trend towards direct IP over WDM (bypassing
SONET equipment)
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Dense Wave Division Multiplexing (DWDM) Cost Savings Versus SONET Take advantage of DWDM bit-rate independence and lack of
scaling capital expenditure as compared to SONET
Source: NGN - 1998 Conference Proceedings
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Technology:Smart Cards Definition
– Plastic card with embedded silicon chip, 1 to 8 kilobytes of memory, microprocessor, operating system in ROM (Read Only Memory).
Capabilities– Typical 1- 8Kbytes storage memory– 32kByte chips being developed– Price range now $2 to $25 per card (8Kb cards @$2)
Medical Applications– Military experimenting in triage situations (Dog Tag replacements)– Insurance firms considering usage to
• reduce cost of accounting for medical• future storage of patient records (assuming medical records policy
changes takes place) Progress
– Slow, with focus on billing/accounting– Expected to take off in near future if policy on records change
Future– Could be useful in remote areas given inexpensive readers available
(current readers cost $300 +)
Reference: 3GI home page -http://www.3GI.com/
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Technology:Wireless
Today’s Services Basic voice service Fax / Paging (one-way, two-way) Limited e-mail and internet access
9.6 Kbps to 14.4 Kbps
Base StationBSC
VLR/HLR/
AUC/E IR
M SC(Circuit Sw itched Cards)
ISP
PST N
AUC Authentication CenterBSC Base Station ControllerEIR Equipment Identification RegisterHLR Home Location RegisterISP Internet Service ProviderMSC Mobile Switching CenterPSTN Public Switched Telephone NetworkVLR Visitor Location Register
Key:
Base Station
H.320
BSC
VLR/HLR/AUC/EIR
MSC
IP Network
PSTNn X DS1 or DS-3
IP Gateway
Corporate Intranet
VideoServer
3G Wireless Switch
Air Interface: 3G CDMA Based 5 MHz RF Channels
Future
Future Services Digital Voice and Data services Fax / Paging (two-way) Full High Speed E-mail / internet access
28.8 Kbps to n x 1.5 Mbps
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Technology: Other Available Services Supporting Telemedical Applications
Digital Subscriber Loop Services Cable Modems Frame Relay (predecessor for IP networks) Wireless services (cellular, satellite, other) Faster CPUs and memory storage explosion Future growth of digital record keeping acceptance
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Technology: Summary Technology is changing exponentially Internet services in urban areas represent a possible
outreach approach to the public with high bandwidth offerings and ubiquity of the services
Cost of bandwidth is dropping rapidly Telemedicine requires bandwidth which is now becoming
more affordable and available in urban areas Urban areas are ripe for considering new technology
applications as never before (e.g., wireless beyond the pager and cell phone explosion
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Technology:Recommendations
Perform the cost-benefit tradeoff studies now to identify longer term applications of new technologies in telemedicine
Due to the explosive nature of technology changes be flexible in buying into the new offerings (2 to 3 year contracts with options to change or get out; lease as much as possible, don’t own your systems)
Finally, encourage changes in insurance and legal restrictions to allow more telemedicine as facts prove their benefits.
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Contact Information
Frank E. Ferrante
Mitretek Systems, Inc.
Senior Manager, Systems Engineering and Acquisition
Center for Telecommunications and Advanced Technology